Regulation, risk and safety of Faecal Microbiota Transplant

Merrick, Blair; Allen, Liz; Zain, Nur Masirah M.; Forbes, Ben; Shawcross, Debbie L.

doi:10.1016/j.infpip.2020.100069

Cited by 70 publications

(60 citation statements)

References 64 publications

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“…FMT treatment is generally considered safe, especially after extensive donor screening and testing ( 169 , 170 ) but remains technically challenging (donor selection and preparation of the fecal transplant). In the future, specific supplementation of a (combination of) beneficial strains could be more feasible on a larger scale ( 169 ).…”

Section: Therapeutic Strategies Targeting the Gut Microbiota And Metamentioning

confidence: 99%

“…Fecal microbiota transplantation (FMT) is the infusion of feces from a healthy donor into the gut of a recipient with the aim of targeting microbiota composition and is a promising strategy for combating disease associated with microbiota imbalance (163)(164)(165)(166)(167)(168). FMT treatment is generally considered safe, especially after extensive donor screening and testing (169,170) but remains technically challenging (donor selection and preparation of the fecal transplant). In the future, specific supplementation of a (combination of) beneficial strains could be more feasible on a larger scale (169).…”

Section: Fecal Microbiota Transplantationmentioning

confidence: 99%

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Contribution of Gut Microbiota to Immunological Changes in Alzheimer’s Disease

et al. 2021

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Emerging evidence suggests that both central and peripheral immunological processes play an important role in the pathogenesis of Alzheimer’s disease (AD), but regulatory mechanisms remain unknown. The gut microbiota and its key metabolites are known to affect neuroinflammation by modulating the activity of peripheral and brain-resident immune cells, yet an overview on how the gut microbiota contribute to immunological alterations in AD is lacking. In this review, we discuss current literature on microbiota composition in AD patients and relevant animal models. Next, we highlight how microbiota and their metabolites may contribute to peripheral and central immunological changes in AD. Finally, we offer a future perspective on the translation of these findings into clinical practice by targeting gut microbiota to modulate inflammation in AD. Since we find that gut microbiota alterations in AD can induce peripheral and central immunological changes via the release of microbial metabolites, we propose that modulating their composition may alter ongoing inflammation and could therefore be a promising future strategy to fight progression of AD.

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Section: Therapeutic Strategies Targeting the Gut Microbiota And Metamentioning

confidence: 99%

Section: Fecal Microbiota Transplantationmentioning

confidence: 99%

Contribution of Gut Microbiota to Immunological Changes in Alzheimer’s Disease

et al. 2021

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“…Moreover, the current literature lacks information about the long-term administration of probiotics; therefore, the possible horizontal transfer of antibiotic resistance genes favored by their supplementation cannot be excluded. Likewise, because stool contains thousands of microorganisms and a vast number of metabolites, FMT represents a constant risk of pathogens or commensals transfer to donors that may harmfully affect them[ 88 ].…”

Section: Discussionmentioning

confidence: 99%

Microbiota shaping — the effects of probiotics, prebiotics, and fecal microbiota transplant on cognitive functions: A systematic review

Baldi¹,

Mundula²,

Nannini³

et al. 2021

WJG

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BACKGROUND Dementia is a chronic progressive neurological disease affecting millions of people worldwide, and represents a relevant economic burden for healthcare systems. Although its pathogenesis is still unknown, recent findings have reported that a dysregulated gut-brain axis communication, a fundamental relationship mediated by several host and microbial molecules, is associated with cognitive disorders. In addition, gut microbiota manipulation reduces neuroinflammation, improving cognitive function by restoring the functional gut-brain axis. AIM To better define the effects of probiotics, prebiotics, synbiotics, and fecal microbiota transplant (FMT) on cognitive function. METHODS We performed a literature search of human randomized clinical trials to examine the effects of the administration of probiotics, prebiotics, synbiotics, or FMT on cognition outcomes in healthy or sick people of every age, sex, and nationality. We systematically searched Embase, Medline/PubMed, Cochrane Library, central and clinicaltrials.gov databases with a combination of comprehensive terms related to cognition and gut microbiota manipulation. Then we carefully reviewed and synthesized the data by type of study design and setting, characteristics of the studied population, kind of intervention (strain type or mixture type, dosage, and frequency of administration), control treatment, inclusion and exclusion criteria, follow-up duration, and cognitive or memory outcomes. RESULTS After examining the titles and abstracts, the initial literature screening identified 995 articles, but we added 23 papers in our systematic review. The analyses of these selected studies highlighted that both probiotic supplementation and FMT improved cognitive function regardless of the type and posology of administration and the adopted cognitive tests and questionnaires. We found that most of the studies conducted in healthy people showed a significant positive effect of the intervention on at least one of the performed cognitive tests. Regarding unhealthy subjects, while FMT and especially probiotic administration had multiple beneficial effects on different cognitive functions, supplementation with prebiotics did not provide any cognitive improvement. CONCLUSION Probiotic supplementation and FMT may represent a promising strategy to restore gut eubiosis and enhance the cognitive functions of healthy people and patients with neurological disorders.

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“…The donated stool was manufactured into capsules without ESBL screening. In response, the FDA created a national alert and mandated additional screening for ESBLs [ 3 ]. In addition to the short-term risk of infection transmission, a recent prospective registry study [ 4 ] suggested that 4% of participants developed new infectious diseases between 1 and 6 months; some were related to FMT, but others were not.…”

Section: Adverse Events Associated With Fmtmentioning

confidence: 99%

Fecal Microbiota Transplantation: Is It Safe?

Park

Seo

2021

Clin Endosc

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FMT is usually considered safe, and the common side effects are minor adverse events, including transient diarrhea, abdominal cramps or pain, low-grade fever, bloating, flatulence, and constipation (Table 1). 1 However, we should consider the possible uncommon severe side effects following FMT. Adverse events related to stool bankAmong the adverse events, the risk of infection transmission after FMT has been a concern, especially after an Food and Drug Administration (FDA) report of two cases of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) infection (one death) and six cases of Shiga toxin-producing E. coli infection (two subsequent deaths), probably transmitted through the donor stool. 2 The donated stool was manufactured into capsules without ESBL screening. In response, the FDA created a national alert and mandated additional screening for ESBLs. 3 In addition to the short-term risk of infection transmission, a recent prospective registry study 4 suggested that 4% of participants developed new infectious diseases between 1 and 6 months; some were related to FMT, but others were not.

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Regulation, risk and safety of Faecal Microbiota Transplant

Cited by 70 publications

References 64 publications

Contribution of Gut Microbiota to Immunological Changes in Alzheimer’s Disease

Contribution of Gut Microbiota to Immunological Changes in Alzheimer’s Disease

Microbiota shaping — the effects of probiotics, prebiotics, and fecal microbiota transplant on cognitive functions: A systematic review

Fecal Microbiota Transplantation: Is It Safe?

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